BMJ. 1996 Feb 10;312(7027):335-8. Unique Identifier : AIDSLINE
OBJECTIVE--To document the range of disease in African children infected
with HIV. DESIGN--Necropsy results in consecutive children aged 1 month
or more who were HIV positive and in children who were HIV negative for
comparison; IgA western blots on serum samples from children under 2
years of age who were positive for HIV-1 to test the validity of routine
HIV serology. SETTING--Largest hospital in Abidjan, Cote d'Ivoire.
SUBJECTS--78 children who were HIV positive and 77 children who were HIV
negative on whom a necropsy was performed; their median ages at death
were 18 and 21 months respectively. 36 HIV positive children and 29 HIV
negative children were 1-14 months old; 42 HIV positive and 48 HIV
negative children were > or = 15 months old. MAIN OUTCOME
MEASURES--Cause of death and prevalence of diseases confirmed
pathologically. RESULTS--Respiratory tract infections were more common
in HIV positive than in HIV negative children (73 (94%) v 52 (68%); P <
0.05), and were aetiologically heterogeneous. Pneumocystis carinii
pneumonia was found in 11 out of 36 (31%) HIV positive children aged <
15 months, but in no HIV negative children. Among older children measles
was more common in HIV positive children (8/42 (19%) v 2/48 (4%); P <
0.06). Pyogenic meningitis was present in similar proportions of HIV
positive and HIV negative children aged < 15 months (7/36 (19%) and 7/29
(24%)). In HIV positive children tuberculosis (1/78), lymphocytic
interstitial pneumonitis (1/78), and HIV encephalitis (2/78) were rare.
CONCLUSIONS--There is greater overlap between diseases associated with
HIV infection and other common health problems in African children than
there is in adults. Compared with adults, HIV positive children had a
high prevalence of P carinii pneumonia and a low prevalence of
tuberculosis. Measles, but not malaria, was associated with HIV
infection.
Autopsy AIDS Dementia Complex/EPIDEMIOLOGY AIDS-Related Opportunistic
Infections/EPIDEMIOLOGY Cause of Death Cote d'Ivoire/EPIDEMIOLOGY
Human HIV Infections/COMPLICATIONS/*MORTALITY HIV Seronegativity HIV
Seropositivity/COMPLICATIONS Infant Malaria/EPIDEMIOLOGY
Measles/EPIDEMIOLOGY Meningitis/EPIDEMIOLOGY Prevalence Respiratory
Tract Infections/EPIDEMIOLOGY Support, Non-U.S. Gov't Support, U.S.
Gov't, P.H.S. JOURNAL ARTICLE